TRAVEL EXPENSE REPORT
The University of Western Ontario
Department of Financial Services
Suite 6100, Support Services Building
London, Ontario N6A 3K7
travel@uwo.ca
For NON-UWO Employees Only
(UWO Employees must use the online
Travel and Expenses Centre at finance.uwo.ca)
SHADED AREAS FOR DEPARTMENT OF FINANCIAL SERVICES USE ONLY.
Invoice #
Y
Vendor #
Y
M
D
D
Reference Description
9
E
(Please check)
CLAIMANT'S NAME (Please print)
Last
M
Graduate Student:
First
Initial
Research:
Faculty/ Department/ Street Address
E-Mail Address
No
Yes
No
Special Instructions
Room Number/ Building/ City
Province/ State
Yes
Postal/ Zip
Phone Number
Currency
Cheque Handling
ITINERARY (Mandatory)
Purpose of Travel or Expense (Required):
Location:
Dates:
INSTRUCTIONS:
1. Complete the top part of this page by indicating your name and department address (or home address).
2. On Page 2 complete the expense categories A through D as applicable.
3. Complete Section E on Page 4 if you have any Cash Advances or if any expenses were paid directly by the University, on an Advance line.
4. Convert all foreign/US amounts to Canadian currency using the exchange rate at the time the expenses were incurred.
5. Allow 3-5 working days for processing the claim.
Total Expenses (from page 2)
Total Advances/ Direct Expenses
(from page 4)
1
$
2
$
Return to UWO
1 - 2
$
Due to Claimant
$
$1.00 neither paid nor refunded
EXPENSE CATEGORIES
A Transportation
Dates
From
To
Page 2
Receipt
Total
Description (for car, show km x Rate)
Deduct Personal
Expenses included
Currency
Exchange
Total of A
Amount
B Accommodation
From Dates
Speed Code
Account #
Fund
Program
Receipt
Total
Description
To
Dept/ Org.
Speed Code
C Meals & Business Hospitality
From Dates To
Account #
Fund
Dept/ Org.
Deduct Personal
Expenses included
Program
Receipt
Total
Description
Currency
Exchange
Speed Code
D Supplies/ Subject Fees/ Misc.
From Dates To
Account #
Fund
Dept/ Org.
Deduct Personal
Expenses included
Program
Receipt
Total
Description
Speed Code
Account #
Fund
Dept/ Org.
Total Expenses: A + B + C + D
(Carry forward to page 1)
$
Claim
Amount
$
Project/ Grant
Deduct Personal
Expenses included
Program
$
Currency
Exchange
Currency
Exchange
Total of D
Amount
Claim
Amount
Project/ Grant
Total of C
Amount
$
Project/ Grant
Total of B
Amount
Claim
Amount
Claim
Amount
$
Project/ Grant
1
Page 3
STAPLE RECEIPTS HERE
GENERAL GUIDELINES
1. Please ensure that all claims for expenses are in accordance with University policy.
2. A copy of the Travel & Expenses Reimbursement Policy 2.16 can be found at www.uwo.ca/finance/travel and includes a link to the new Travel
& Expenses Reimbursement Procedures. These documents provide the current Mileage rates and Meal guidelines.
3. Invoices for supplies that exceed $500 or equipment that exceeds $2,000, should be paid through the Purchase Order System.
4. Please attach all receipts and include an explanation for any of the following items:
.. Missing receipts (Attestation form required)
.. Air fare that exceeds Economy Rate
.. Room rates in excess of the Basic Rate
.. Meal receipts that exceed the guidelines
5. Additional resources and forms can be found on the Financial Services website www.uwo.ca/finance
EXPLANATION OF POLICY/PROCEDURE EXCEPTIONS (additional space provided on Page 4)
APPROVALS
(Expense reports missing Approval Signatures will be returned)
CLAIMANT:
I certify that all expenses submitted are reasonable and in accordance with University policy and will not be used as claims to other organizations for income tax purposes. Expenses reflect
due regard for value for money, and personal expenses have been deducted. Exceptions to policy have been explained in writing and outstanding Cash Advances and prepaid expenses
have been accounted for.
Print Name:
Signature:
Date:
PRINCIPAL INVESTIGATOR (Research Grants Only):
I certify that these expenses are in accordance with the budget of the grant/ contract and they adhere to the policies and procedures of the granting agency(ies).
Print Name:
Signature:
Date:
BUDGET UNIT HEAD/DESIGNATE:
I certify that the expenses are for University purpose only, and are in accordance with University policy. Exceptions to the Policy, which are documented by the Claimant, are reasonable
under the circumstances.
Print Name:
Signature:
Date:
Page 4
E. Cash Advances/ Prepaid Costs (See Section 13.0 of Travel & Expenses Reimbursement Procedures 2.16)
1. Section E should be completed if you have obtained a Cash Advance or if you have used a Purchase Order to pay for airline or train tickets
(and the order was charged to the 645100 account). The expense should be included in the appropriate category on Page 2, and the amount and
account charges on the Purchase Order must be shown in this section.
2. Tickets obtained through our Preferred Travel Agencies should not be recorded in this section. However, the original documentation should be
included with the Expense Report for audit purposes.
Date
Amount
$
P.O. # / Advance #
Speed Code
Description
Account #
Fund
Dept./ Org.
Total of E
(Carry forward to page 1)
Program
Project/ Grant
2
EXPLANATION OF POLICY/PROCEDURE EXCEPTIONS (Continued)
Revised Jan. 12